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In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.

The purpose of this paper is to describe and analyse two approaches to paramedic service clinical governance and quality management from the perspective of two groups of paramedics and paramedic managers working in North America.

A case study approach was utilised to describe and analyse paramedic service medical direction in North America and contrast this with the professional self-governance and clinical governance systems operating in other high-income countries. Researchers interviewed participants at two remote North American sites, then completed transcription and thematic analysis.

Participants identified three themes: first, resourcing, regulatory frameworks and fragmentation; second, independent practice facilitators and barriers; and third, paramedic roles and professionalisation. Those trained outside North America tended to identify self-regulation and clinical governance as the preferred approach to quality management. Few participants had considered paramedicine becoming a self-regulating health profession.

In North America, the “medical direction” model is the dominant approach employed to ensure optimal patient outcomes in paramedic service delivery. In contrast, other comparable countries employ paramedic self-regulatory systems combined with clinical governance to achieve the same ends. This is one of two studies to examine medical direction from the perspective of paramedics and paramedic managers.

The rapid advancement of digital technologies has fundamentally changed the competitive dynamics of the logistics service industry and forced incumbent logistics service providers (LSPs) to digitalize. As many LSPs still struggle in advancing their digital transformation (DT), the purpose of this study is to discover barriers and identify organizational elements and associated leading practices for DT success at LSPs.

This study utilizes a two-stage approach. Stage 1 is devoted to a literature review. Stage 2, based on multiple case studies, analyzes information collected across nine international and global LSPs.

This research derives a practice-based definition of DT in the logistics service industry, and it has identified five barriers, eight success factors and associated leading practices for DT. The main obstacles LSPs struggle with, are the complexity of the logistics network and lack of resources, while the main success factor is a leader having and executing a DT vision, and creating a supportive organizational culture.

The results contribute to the emerging field of DT within the logistics and supply chain management literature and provide insights for practitioners regarding how to effectively implement it in a complex industry.

The authors analyze DT from the perspective of LSPs, traditionally not viewed as innovative companies. This study compares their DT with that of other companies.

Postsecondary institutions that purport to build leaders are ubiquitous. Yet, given such ubiquity, the curriculum and co-curriculum dedicated to student leadership development is diffuse as an overall field of practice and lacks firm grounding in matching consensus outcomes for leader development to specific principles of teaching and learning. We propose a conceptual model for leader development of undergraduates that describes what leadership education should strive to accomplish.

Recent scholars (Leroy et al., 2022) suggest such lack of consensus and weak structure stems from a lack of commitment to defining the ultimate goals for leader development programs, matching curriculum and pedagogy to meet these goals, and then rigorously evaluating programs. Our proposed model illustrates a structure of leadership skill mastery founded in adult constructive development theory, applies a range of adult learning principles, and includes several suggestions for specific curricular and pedagogical applications. We describe each aspect of this conceptual model and explain how it might be enacted and assessed across diverse postsecondary contexts.

We have no findings to report.

Numerous scholars have advanced models that seek to define and provide a structure for “leadership.” The novelty of our work is to combine the work of other scholars to provide an explicit framework for the work of leadership education in higher education – how to conceptualize “leader development,” how to combine such development with adult learning principles, and what specific curricular and pedagogical elements should be included to achieve intended ends.

The purpose of this study is to understand how Amazon’s threat may impact the Pharmacy Industry as a whole and whether traditional drugstore chains such as consumer value stores (CVS) Pharmacy will need to re-think their business strategy, especially in the digital space, to account for potential disruption.

This is a hypothetical case study used as a teaching exercise to guide the learner through a decision-making process. The case starts by presenting a disruption in the retail pharmacy business that the main character must navigate by using real-world data and insights, provided in the case, to formulate a recommendation.

In an extremely competitive and consolidated pharmacy market, Amazon has the potential to change the business entirely. CVS Health will potentially face strong headwinds from Amazon’s PillPack and a downward trend in prescription sales. Regardless of the new competition, CVS Health continues to be innovative in the space. Instead of being a one-trick pony, CVS has encompassed the mentality of becoming a one-stop-shop by expanding into areas such as specialty pharmacy, health clinics, pharmacy benefits management and innovative digital capabilities.

This paper provides the reader with existing and known information about the evolving retail pharmacy business and allows the reader to interpret the new information to make their own decision on how a digital business strategy team can account for potential disruption.

This study explores how a small minority of social entrepreneurs break free from third sector constraints to conceive, create and grow non-profit organisations that generate social value at scale in new and innovative ways.

Six narrative case histories of innovative social enterprises were developed based on documents and semi-structured interviews with founders and long serving executives. Data were coded “chrono-processually”, which involves locating thoughts, events and actions in distinct time periods (temporal bracketing) and identifying the processes at work in establishing new social ventures.

This study presents two core findings. First, the paper demonstrates how successful social entrepreneurs draw on their lived experiences, private and professional, in driving the development and implementation of social innovations, which are realised through application of their capabilities as analysts, strategists and resources mobilisers. These capabilities are bolstered by personal legitimacy and by their abilities as storytellers and rhetoricians. Second, the study unravels the complex processes of social entrepreneurship by revealing how sensemaking, theorising, strategizing and sensegiving underpin the core processes of problem specification, the formulation of theories of change, development of new business models and the implementation of social innovations.

The study demonstrates how social entrepreneurs use sensemaking and sensegiving strategies to understand and address complex social problems, revealing how successful social entrepreneurs devise and disseminate social innovations that substantially add value to society and bring about beneficial social change. A novel process-outcome model of social innovation is presented illustrating the interconnections between entrepreneurial cognition and strategic action.

This paper investigates the motivations and challenges of women entrepreneurs in Ireland, assessing the role of policies and Enterprise Ireland (EI) support for women-led companies and high potential start-ups (HPSUs). It employs the gendered theory of entrepreneurship and opportunity recognition theory to analyse the enablers and obstacles to women’s entrepreneurship, particularly in the context of EI’s support, aiming to suggest improvements.

Grounded in a feminist epistemology and employing a mixed-methods approach, a targeted survey explores motivations, barriers and supports the needs of female entrepreneurs in Ireland, offering a comprehensive gender perspective evaluation for policy enhancement.

Findings note a shift in Irish women’s entrepreneurship motivations and outlines major hurdles like limited funding and work–life balance issues. It recommends policy enhancements in data collection, website usability, financial guidance and childcare support.

This paper aims to highlight the impact of gender-specific factors on entrepreneurship, the study highlights the importance of ongoing data collection and gender comparative analyses. It advocates for women mentoring networks and improved financial support to build a more inclusive entrepreneurial environment in Ireland, with potential global implications.

This study is unique for its in-depth exploration into Irish female entrepreneurship challenges, this study proposes actionable strategies with local and global relevance. Advocating for caregiving support integration and women’s increased involvement in tech, it offers a blueprint for fostering female entrepreneurship. It contributes to global discussions on creating supportive, equitable entrepreneurial ecosystems, serving as a valuable resource for advancing gender inclusivity and equity in entrepreneurship worldwide. It identifies scope for integration of a feminist epistemology in policy development.

The global Covid-19 pandemic is posing considerable challenges for governments throughout the world and has and will have a significant influence on the shape of peoples social and economic life and wellbeing in the short and longer term. This opinion paper discusses the current health policy response adopted in England to control or manage the epidemic and identifies the key sociological and political influences which have shaped these policies. Drawing on the theoretical approach set out in his recent book, which emphasises the interplay of powerful structural and economic interest groups, the author will consider the influence of the key players. Government policy has tied itself to scientific and medical evidence and protecting the NHS so the key roles of the medical profession, public health scientific community and NHS management and their respective and relative powerful influences will be discussed. The government needs the support of the public if their policies are to be successful, so how have the government addressed maintaining public trust in this “crisis” and how much trust do the public have in the government and what has influenced it? The strong emphasis on social distancing and social isolation in the national government policy response to Covid-19 has placed an increasing public reliance on the traditional and social media for sources of information so how the media has framed the policy will be considered. One policy aim is for an effective vaccine and the influence of the drug industry in its development is discussed. Finally, the role of the state will be discussed and what has shaped its social and economic policies.

Public realm urban regeneration projects aim to provide facilities for the common good such as improved road systems, public parks, museums and cultural institutions. Driven by political priorities, the expected benefits for society comprise of the proposed regeneration outcomes articulated in a masterplan vision. As a philosophical concept, common good in the context of urban regeneration is explored in this study to understand the expectations for major, long-term regeneration projects and the intended project objectives. In the approach to governance, there should be a relationship between monitoring indicators adopted by the regeneration project as part of the governance framework and their alignment with the common good. These concepts are analysed through a case study of the development and reporting of benchmark indicators established at the start of a major 20-year urban redevelopment in 2010. The monitoring and enhancement concept implemented required indicators to be developed and embedded in the regeneration process to, not only monitor, but also enhance sustainability. The longitudinal case study, at the interim point 10 years since the establishment of these indicators, will evaluate the sustainability of the urban regeneration and evaluate current evidence for the common good. The indicators were developed following the principles of a theme orientated framework in line with the UK and Scottish Government approach at that time. The process of indicator development was iterative, refined and finalised through working closely with local authority, Scottish Enterprise and partnership stakeholders (civic oriented organisations) to capture evidence of progress towards the masterplan vision. Ten years on, conclusions examine whether these indicators could be used a proxy for common good. The conclusion will identify the extent to which we would need to revise indicators to address any gaps to become a more accurate measure of common good.